不同剂量甲状腺激素治疗妊娠期亚临床甲状腺功能减退临床效果观察

Clinical Effect of Different Doses of Thyroid Hormone on Subclinical Hypothyroidism in Pregnancy

目的 :探讨不同剂量甲状腺激素治疗妊娠期亚临床甲状腺功能减退(SCH)的临床效果。方法 :选择我院2016年1-12月收治的50例妊娠期亚临床甲状腺功能减退患者,按随机数字表法分为治疗组与对照组,各25例。研究组给予左旋甲状腺钠片(150μg,分早、晚两次口服)治疗;对照组给予左旋甲状腺钠片(75μg,qd)治疗,比较两组患者的甲状腺功能及妊娠期相关并发症发生率。结果 :治疗前两组甲状腺功能相关指标(TSH、FT3、FT4)比较均无统计学差异(P>0.05),治疗后两组TSH水平均较治疗前显著下降,FT3、FT4水平则较治疗前显著上升(P<0.05),且研究组甲状腺功能改善效果优于对照组;研究组妊娠期相关并发症发生率显著低于对照组(P<0.05)。结论 :采用高剂量左旋甲状腺激素治疗妊娠期甲状腺功能减退临床效果显著,妊娠结局良好,适合临床应用。

Objective:To investigate the clinical effect of different doses of thyroid hormone on subclinical hypothyroidism(SCH) in pregnancy.Methods:50 cases of patients with subclinical hypothyroidism in pregnancy were randomly divided into treatment group and control group from January 2016 to December 2016,25 cases in each group.Research group was given levothyroxine sodium tablets(150 μg,divided into early and late two oral); the control group was given levothyroxine sodium tablets(75 μg,qd),the thyroid function and incidence of complications in two groups were compared.Results:The thyroid function indexes(TSH,FT_3,FT_4) of two groups before the treatment had no statistically significant difference(P>0.05).After treatment,TSH levels of two groups were significantly decreased compared with before treatment,FT_3,FT_4 levels were significantly increased(P<0.05),and the effect of study group was better than that of the control group in improving thyroid function.The incidence of pregnancy related complications in the study group was significantly lower than that of the control group(P<0.05).Conclusion:High dose levothyroxine is effective in the treatment of hypothyroidism in pregnancy,and the outcome of pregnancy is good.It is suitable for clinical application.